Reimbursement Escalation Specialist

Job Title

Reimbursement Escalation Specialist

Reimbursement Escalation Specialist (Plymouth, MN)

As a Reimbursement Escalation Specialist, you will drive resolution of high‑priority, complex payer issues that directly impact accounts receivable, claim aging, and cash collections.

• Escalate, track, and report reimbursement trends to the Revenue Cycle Management team on a daily, weekly, and monthly basis.
• Partner with insurance carriers to clarify claim issues and manage payer prepayment audits.
• Serve as a point of escalation for complex claims, addressing inquiries and requests from cross‑functional teams including Cash Application Specialists, Payer Relations, Patient Collections, and Reimbursement.
• Review and approve claims adjustment requests to validate all required collection actions have been completed in accordance with work instructions, while maintaining compliance with payer‑specific requirements for claims processing, appeals, credits, and refunds.
• Build strong working relationships with operations and collection teams to reduce claim payment turnaround time.
• Communicate with patients regarding outstanding balances, including establishing and approving payment plans as appropriate.

• You’ve acquired 4+ years of experience in medical claims billing or collections and 1+ years in a lead or supervisory role within Revenue Cycle Management.
• Your skills include:
  • Knowledge of insurance payers, including Medicare, Medicaid, Blue Cross Blue Shield and commercial plans.
  • Managing denials, claim appeals and claim recoupments.
  • Knowledge of eligibility of benefits and authorizations.
• You have a high school diploma or GED (required) or equivalent work experience or combination of secondary education and work experience
• You must be able to successfully perform the following minimum Physical, Cognitive and Environmental job requirements with or without accommodation for this position.
• You are an excellent communicator, both written and verbal.

We believe that we are better together than apart. For our office-based teams, this means working in-person at least 3 days per week. Onsite roles require full-time presence in the company’s facilities. Field roles are most effectively done outside of the company’s main facilities, generally at the customers’ or suppliers’ locations.

This is an office role.

We are a health technology company. We built our entire company around the belief that every human matters, and we won't stop until everybody everywhere has access to the quality healthcare that we all deserve. Do the work of your life to help improve the lives of others.

• Learn more about our business.
• Discover our rich and exciting history.
• Learn more about our purpose.
• Learn more about our culture.

The pay range for this position in Plymouth, MN is $34.00 to $55.00.

The actual base pay offered may vary within the posted ranges depending on multiple factors including job‑related knowledge/skills, experience, business needs, geographical location, and internal equity.

In addition, other compensation, such as an annual incentive bonus, sales commission or long‑term incentives may be offered. Employees are eligible to participate in our comprehensive Philips Total Rewards benefits program, which includes a generous PTO, 401k (up to 7% match), HSA (with company contribution), stock purchase plan, education reimbursement and much more. Details about our benefits can be found here.

At Philips, it is not typical for an individual to be hired at or near the top end of the range for their role and compensation decisions are dependent upon the facts and circumstances of each case.

US work authorization is a precondition of employment. The company will not consider candidates who require sponsorship for a work‑authorized visa, now or in the future.

Company relocation benefits will not be provided for this position. For this position, you must reside in or within commuting distance to Plymouth, MN.

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This requisition is expected to stay active for 45 days but may close earlier if a successful candidate is selected or business necessity dictates. Interested candidates are encouraged to apply as soon as possible to ensure consideration.

Philips is an Equal Employment and Opportunity Employer including Disability/Vets and maintains a drug‑free workplace.